The central focus of this continuation application will be to evaluate the long-term effects of prenatal cocaine/polydrug exposure on the neuropsychological, emotional/behavioral, and educational functioning of a large representative sample of 12-year-old African-American children, born full-term and followed prospectively since birth. Retention of the birth cohort (n=476, of whom 253 were cocaine-exposed), at the 7-year visit was 87% (93% for those families still residing in the South Florida area). In the past 6 months, 89% (426) of the total cohort have been successfully contacted. Research indicates that in utero cocaine/polydrug exposure results in significant prenatal and reproductive risks. The long-term consequences remain unclear, although researchers and clinicians alike postulate neuropsychological effects that may influence academic, psychological, and social adaptation. Despite these concerns, there are few well-controlled prospective studies evaluating school-aged cocaine/polydrug-exposed children. Our findings through age 7 indicate that prenatal cocaine/polydrug exposure has a negative impact on fetal growth and infant neurobehavioral functioning, language abilities and attentional processing. Additional preliminary findings for the 7-year visit suggest potential decrements in neuropsychological and academic functioning. Children and caregivers will be seen for a comprehensive evaluation at age 12 years. Outcomes will be assessed within the framework of the following aims, utilizing state of the art longitudinal analyses incorporating previously collected child and caregiver data at 4, 8, 12, 18, and 24 months and 3, 4, 5, and 7 years of age. Analyses will take into account prenatal exposure to other drugs and important socio-demographic and environmental variables, as well as individual level determinants of outcomes. AIM 1: To evaluate effects through age 12 years of prenatal cocaine exposure on child neuropsychological functioning, particularly in the key domains of executive functioning, attention, memory, and language. AIM 2: To estimate prenatal cocaine exposure's influence on educational and emotional/behavioral outcomes, and early onset of high risk behaviors (e.g. substance use, sexual activity, school truancy, conduct problems/criminal behavior) and to test for the mediating influence of neuropsychological functioning on these relationships. AIM 3: To estimate the ameliorating or exacerbating effects of the caregiving, family, and community environment on neuropsychological, educational, and emotional/behavioral outcomes, and onset of high risk behaviors.